Critical Care Nursing Questions and Answers PDF

Critical Care Nursing Questions and Answers PDF Related

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The emergency department (ED) nurse is initiating therapeutic hypothermia in a patient who has been resuscitated after a cardiac arrest. Which actions in the hypothermia protocol can be delegated to an experienced licensed practical/vocational nurse (LPN/LVN) (select all that apply)?

  • A. Continuously monitor heart rhythm.
  • B. Check neurologic status every 2 hours.
  • C. Place cooling blankets above and below the patient.
  • D. Give acetaminophen (Tylenol) 650 mg per nasogastric tube.
Correct Answer: D

Rationale: Correct Answer: D - Give acetaminophen (Tylenol) 650 mg per nasogastric tube.

Rationale: LPNs/LVNs are trained to administer medications, including oral and nasogastric routes. Giving acetaminophen via nasogastric tube is within their scope of practice. LPNs/LVNs should have the knowledge and skills to safely administer this medication as part of the hypothermia protocol.

Summary of other choices:
A: Continuously monitor heart rhythm - This requires specialized training and skills typically within the scope of registered nurses or cardiac monitoring technicians.
B: Check neurologic status every 2 hours - Assessing neurologic status requires critical thinking and clinical judgment, which are typically responsibilities of registered nurses.
C: Place cooling blankets above and below the patient - Positioning and managing cooling devices may require specific training and should be done under the supervision of a registered nurse.

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The nurse is caring for a patient who has sustained blunt trauma to the left flank area, and is evaluating the patient’s urinalysis results. The nurse should become concerned when

  • A. creatinine levels in the urine are similar to blood levels of creatinine.
  • B. sodium and chloride are found in the urine.
  • C. urine uric acid levels have the same values as serum levels.
  • D. red blood cells and albumin are found in the urine.
Correct Answer: D

Rationale: The correct answer is D because the presence of red blood cells and albumin in the urine indicates possible kidney damage from the blunt trauma. This is concerning as it may suggest renal injury or dysfunction.

A: Creatinine levels in the urine being similar to blood levels is normal as creatinine is filtered by the kidneys.
B: Sodium and chloride being present in the urine is expected as they are components of urine.
C: Urine uric acid levels matching serum levels is common as uric acid is excreted by the kidneys.

In summary, the presence of red blood cells and albumin in the urine is abnormal and indicates potential kidney damage, making it the correct answer.

A patient has just been admitted to the ICU after being in a severe auto accident and losing one of her legs. Her husband has his hand over his heart and complains of a rapid heart rate. The nurse recognizes his condition as a sign of which stage of the general adaptation syndrome to stress?

  • A. Alarm stage
  • B. Exhaustion stage
  • C. Resistance stage
  • D. Adaptation stage
Correct Answer: A

Rationale: The correct answer is A: Alarm stage. The husband's rapid heart rate indicates the initial alarm reaction to stress, characterized by physiological arousal. This stage involves the body's fight-or-flight response to a stressor. In this scenario, the husband is experiencing the physiological effects of the stressful situation, such as the auto accident and loss of a limb. The other choices are incorrect because:
B: Exhaustion stage occurs if stress continues without relief, leading to depletion of resources and increased vulnerability to illness.
C: Resistance stage is the body's attempt to adapt and cope with the stressor after the initial alarm reaction.
D: Adaptation stage is not a recognized stage in the general adaptation syndrome model.

A nurse decides to seek certification in critical care nursing. What is the most important benefit for the individual nurse in becoming certified in a specialty?

  • A. It will result in a salary increase.
  • B. It is required to work in critical care.
  • C. It demonstrates the nurses personal expertise.
  • D. It is mandated by employers.
Correct Answer: C

Rationale: The correct answer is C because obtaining certification in critical care nursing demonstrates the nurse's personal expertise in the specialty. Certification confirms the nurse's advanced knowledge and skills, enhancing professional credibility and potential for career advancement. This choice focuses on the individual nurse's competency and dedication to the specialty.

Incorrect choices:
A: Salary increase is not the primary benefit of certification, although it may be a potential outcome.
B: Certification is often preferred but not always required to work in critical care.
D: Employers may encourage certification, but it is not always mandated.

The patient’s spouse is very upset because the patient, who is near death, has dyspnea and restlessness. The nurse explains what options to decrease the discomfort?

  • A. Respiratory therapy treatments
  • B. Opioid medications given as needed
  • C. Incentive spirometry treatments
  • D. Increased hydration.
Correct Answer: B

Rationale: The correct answer is B: Opioid medications given as needed. Opioids are indicated for managing dyspnea and restlessness in palliative care by providing relief from symptoms. They act as potent analgesics and can help decrease the distress associated with difficult breathing and restlessness. Respiratory therapy treatments (A) and incentive spirometry treatments (C) may not address the immediate discomfort caused by dyspnea and restlessness. Increased hydration (D) may not directly alleviate the symptoms and could potentially worsen the patient's discomfort.

After the return of spontaneous circulation following the resuscitation of a patient who had a cardiac arrest, therapeutic hypothermia is ordered. Which action will the nurse include in the plan of care?

  • A. Apply external cooling device.
  • B. Check mental status every 15 minutes.
  • C. Avoid the use of sedative medications.
  • D. Rewarm if the temperature is <91°F (32.8°C).
Correct Answer: A

Rationale: The correct answer is A: Apply external cooling device. Therapeutic hypothermia is a treatment used to protect the brain after cardiac arrest by lowering the body temperature. The nurse should use external cooling devices, such as cooling blankets or ice packs, to achieve and maintain the desired temperature. This method allows for precise temperature control and monitoring. Checking mental status every 15 minutes (choice B) is not the priority as maintaining the temperature is crucial. Avoiding sedative medications (choice C) may be necessary to accurately assess the patient's neurological status. Rewarming if the temperature is <91°F (32.8°C) (choice D) is incorrect as the goal is to maintain hypothermia for a specific duration before gradual rewarming.

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